CHAPTER 233: EYE CLINIC: Ophthalmology and … · 2018-01-31 · Chapter 233: Eye Clinic:...

Department of Veterans Affairs PG-18-9: Space Planning Criteria Veterans Health Administration May 31, 2017 Washington, DC 20420

Chapter 233: Eye Clinic: Ophthalmology and Optometry Services - Page 1 of 33

CHAPTER 233: EYE CLINIC: OPHTHALMOLOGY AND OPTOMETRY SERVICES

1 PURPOSE AND SCOPE ........................................................................................... 233-2

2 DEFINITIONS ........................................................................................................... 233-2

3 OPERATING RATIONALE AND BASIS OF CRITERIA ............................................. 233-4

4 OPHTHALMOLOGY SERVICE INPUT DATA STATEMENTS .................................. 233-6

5 OPHTHALMOLOGY SPACE CRITERIA ................................................................... 233-7

6 OPTOMETRY SERVICE INPUT DATA STATEMENTS .......................................... 233-16

7 OPTOMETRY SERVICE SPACE CRITERIA .......................................................... 233-18

8 OPTICAL FITTING AREA INPUT DATA STATEMENTS ......................................... 233-27

9 OPTICAL FITTING SPACE CRITERIA.................................................................... 233-28

10 PLANNING AND DESIGN CONSIDERATIONS ...................................................... 233-28

11 FUNCTIONAL RELATIONSHIPS ............................................................................ 233-31

12 FUNCTIONAL DIAGRAMS ..................................................................................... 233-32



1 PURPOSE AND SCOPE This document outlines Space Planning Criteria for Chapter 233: Ophthalmology and Optometry Services. It applies to all medical facilities at the Department of Veterans Affairs (VA).

The following policy documents have been reviewed, referenced and incorporated as appropriate:

VHA Handbook 1174.05: Outpatient Blind and Vision Rehabilitation Clinic Procedures, July 1, 2011

OMB Memorandum M-12-12: Promoting Efficient Spending to Support Agency Operations, May 11, 2012 (Section 3: Freeze the Footprint)

2 DEFINITIONS Accessible: A site, building, facility, or portion thereof that complies with provisions outlined in the Architectural Barriers Act of 1968 (ABA).

Affiliated: An arrangement whereby a school of medicine or optometry agrees to staff a VA facility with faculty physicians (ophthalmologists), optometrists, residents and interns / externs. In return, the VA provides the medical or optometry school with a venue to train new physicians / optometrists. In this arrangement, the VA retains responsibility for the care of its patients while the school of medicine or optometry retains responsibility for all graduate level education and training.

Architectural Barriers Act (ABA): A set of standards developed to insure that all buildings financed with federal funds are designed and constructed to be fully accessible to everyone. This law requires all construction, renovation, or leasing of sites, facilities, buildings, and other elements, financed with federal funds, to comply with the Architectural Barriers Act Accessibility Standards (ABAAS). The ABAAS replaces the Uniform Federal Accessibility Standards (UFAS).

Basic Low Vision Services: Basic Low Vision services include prescription of optical low vision devices and a minimum level of visual skills and device training.

Blind Rehabilitation Outpatient Specialist (BROS): A BROS is a multi-skilled, university-trained, and experienced blind rehabilitation instructor who has advanced technical knowledge and competencies at the full performance level in at least two of the following disciplines: orientation and mobility, living skills, manual skills, and visual skills. (per VHA Handbook 1174.05)

Clinic Stop: A clinic stop is one encounter of a patient with a healthcare provider. Per these criteria, the clinic stop is the workload unit of measure for space planning. One individual patient can have multiple clinic stops in a single visit or in one day.

Eye Care Provider: An Optometrist or Ophthalmologist who examines, diagnoses, treats, prescribes medication, and manages the care of patients within his or her clinical privileges as established by the governing body of a healthcare organization.

Full-Time Equivalent (FTE): A staffing parameter equal to the amount of time assigned to one full time employee. It may be composed of several part-time employees whose total time commitment equals that of a full-time employee. One FTE equals a 40 hours per week.



Functional Area: The grouping of rooms and spaces based on their function within a clinical service. Typical Functional Areas are Reception Areas, Patient Areas, Support Areas, Staff and Administrative Areas, Residency and / or Internship / Externship Program Areas.

Input Data Statement: A set of questions designed to elicit information about the healthcare project in order to create a Program for Design (PFD) based on the criteria parameters set forth in this document. Input Data Statements could be Mission related, based in the project’s Concept of Operations; and Workload or Staffing related, based on projections and data provided by the VHA or the VISN about the estimated model of operation. This information is processed through mathematical and logical operations in VA-SEPS.

Low Vision: A combination of visual acuity, visual field loss, contrast sensitivity loss, loss of stereopsis, or eye motility impairment that impacts patient safety or impairs or restricts one or more activities of daily living.

Low Vision Therapy: Low Vision Therapy provides an individual with low vision to use his or her residual vision. This may also include training in the use of low vision and other aids in everyday situations and activities of daily living. Low Vision Services including Basic, Intermediate, Polytrauma Facility, Advanced, Visual Impairment Center to Optimize Remaining Sight (VICTORS), Polytrauma Rehabilitation Network Site, as well as Polytrauma Rehabilitation Center which may include Low Vision Services have separate staffing, space, and workload requirements based upon the level and intensity of vision rehabilitation care provided.

Ophthalmologist: An ophthalmologist is a physician who specializes in the comprehensive care of the eyes and visual system. An ophthalmologist is medically trained and qualified to diagnose and treat all eye and visual system problems. An ophthalmologist can deliver total eye care, as well as diagnose general diseases of the body. An ophthalmologist has completed 4 years of college premedical training, 4 or more years of medical school, 1 year of internship, and 3 years or more of specialized medical training and experience in eye care. An additional 1 to 3 years may be spent in sub-specialty fellowship training.

Optometrist: Doctors of Optometry are independent primary health care providers who examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye and associated structures, as well as diagnose related systemic conditions. An optometrist typically completes 4 years of baccalaureate training and 4 years of optometry training. Residency training is 1 year beyond attainment of the optometry degree, and fellowship training is for 1 to 2 years beyond the completion of residency training.

Program for Design (PFD): A space program based on criteria set forth in this document and specific information about Concept of Operations, workload projections and staffing levels authorized.

Room Efficiency Factor: A factor that provides flexibility in the utilization of a room to account for patient delays, scheduling conflicts, and equipment maintenance. Common factors are in the 80 to 85% range. A room with 80% room efficiency provides a buffer to assume that this room would be available 20% of the time beyond the planned operational practices of the room. This factor may be adjusted based on the actual and/or anticipated operations and processes of the room / department.

SEPS (VA-SEPS): Acronym for Space and Equipment Planning System, a digital tool developed by the Department of Defense (DoD) and the Department of Veterans Affairs to generate a Program for Design (PFD) and an Equipment List for a VA healthcare project based on specific information entered in response to Input Data Questions. VA-SEPS



incorporates the propositions set forth in all VA Space Planning Criteria chapters. VA-SEPS has been designed to aid healthcare planners in creating a space plan based on a standardized set of criteria parameters.

Visual Impairment Center to Optimize Remaining Sight (VICTORS): Advanced Low Vision Services that provides a full spectrum of optical devices and in-depth visual skills training, along with basic training in activities of daily living and in orientation and mobility.

VIST Coordinator: The VIST Coordinator is the case manager who has responsibility for the coordination of services for severely-disabled visually impaired Veterans and their families. (per VHA Handbook 1174.05)

Workload: Workload is the anticipated number of procedures or suite stops that is processed through a department/service area. The total workload applied to departmental operational assumptions will determine overall room requirements by modality.

3 OPERATING RATIONALE AND BASIS OF CRITERIA A. Space planning criteria have been developed based on research of the clinical and non-

clinical activities involved in various functional areas of Ophthalmology and Optometry Services. These criteria are predicated on established and/or anticipated best practice standards. These criteria are subject to modification and adjustment relative to developments in state-of-the-art equipment, medical practice, and subsequent planning and design.

B. The number of Ophthalmology Exam / Treatment Rooms and Optometry Exam / Treatment Rooms for a project is based on workload projections; size and number of Reception and Support spaces are subsequently determined via ratios and metrics from the resulting number of workload driven Exam / Treatment Rooms. Staff and administrative as well as education spaces are determined by information entered in response to Mission and Staffing questions.

C. Workload Projections for Ophthalmology or Optometry services for a specific VA medical center or hospital project are provided by the VHA Support Service Center (VSSC) or VA Central Office (VACO). The workload projections are generated by methodology based upon the expected veteran population in the respective market / service area. Healthcare planners working on VA medical center or hospital projects will utilize this projected workload as well as specific Mission and Staffing information to generate the Baseline Space Program or Program for Design (PFD) for the project.

D. These criteria are subject to modification relative to development in the equipment, medical practice, vendor requirements, and subsequent planning and design. The selection of the size and type of Ophthalmology and Optometry equipment is determined by VACO upon Veterans Health Administration (VHA) anticipated medical needs.

E. Workload calculation is based on the following parameters:

1. Operating days per year: 250

2. Hours of Operation per day: 8

3. Average length of encounter (ALoE) (in minutes):

Ophthalmology Non-Affiliated: 40 Ophthalmology Affiliated: 50 Optometry Non-Affiliated: 40



Optometry Affiliated: 50

4. Efficiency Factor which refers to the percentage of Hours of Operation per day an Exam / Treatment Room will be in use:

Ophthalmology: 75% Optometry: 80%

5. Minimum workload required to generate one Exam / Treatment Room:

Ophthalmology: 25% of Annual Encounters per Room Optometry: 20% of Annual Encounters per Room

6. Calculation of the Exam / Treatment Room capacity per year:

Operating days per year x Hours of operation per day = Number of

ALoE / 60 minutes annual encounters

Example:

250 operating days per year x 8 hours of operation per day = 3,000

40 / 60 minutes

The Exam / Treatment Room maximum annual capacity is 3,000 encounters per year, assuming 100% utilization.

Exam / Treatment Room annual capacity: 3,000 x 80% = 2,400 annual encounters

7. Calculation of the number of Exam / Treatment Rooms for a project :

Projected Number of Clinic Stops (Workload) = Number of

Exam / Treatment Room annual capacity (annual encounters) projected rooms

Example:

12,900 annual Clinic Stops / 2,400 = 5.38 Exam / Treatment Rooms

5 x 2,400 = 12,000 annual Clinic Stops

12,900 – 12,000 = 900

900 greater than 480 hence provide an additional room (see Table 1 Col 5)

6 Exam / Treatment Rooms will be provided.



TABLE 1: WORKLOAD PARAMETER CALCULATION

SERVICE 1

AVERAGE LENGTH OF CLINIC STOP (minutes)

2

UTILIZATION RATE

3

ANNUAL CLINIC STOPS PER ROOM (ROUNDED)

4

MINIMUM WORKLOAD TO GENERATE ONE ROOM

5 Ophthalmology Non-Affiliated (Stop Code 407)

40 75% 2,250 563

Ophthalmology Affiliated (Stop Code 407)

50 75% 1,800 450

Optometry Non-Affiliated (Stop Code 408)

40 80% 2,400 480

Optometry Affiliated (Stop Code 408)

50 80% 1,920 384

The number of annual clinic stops per room will be used as a criteria parameter to calculate the number of Exam / Treatment Rooms in the Space Criteria section of this document.

4 OPHTHALMOLOGY SERVICE INPUT DATA STATEMENTS A. Mission Input Data Statements

1. Is Ophthalmology Service authorized? (M) 2. Is Ophthalmology Service Affiliated? (M) 3. Is an Electrodiagnostics Room for Ophthalmology Service authorized? (M) 4. Is a Specialty Testing Room for Ophthalmology Service authorized? (M) 5. Is a Low Vision / Polytrauma Training Room for Ophthalmology Service authorized?

(M) 6. Is an Advanced Low Vision Clinic for Ophthalmology Service authorized? (M) 7. Is a VIST Coordinator FTE position for Ophthalmology Service authorized? (M) 8. Is an Ophthalmology Residency Program authorized? (M) 9. Is an Ophthalmology Fellowship Program authorized? (M)

B. Workload Input Data Statements 1. How many annual Ophthalmology Service clinic stops (Stop Code 407) are

projected? (W)

C. Staffing Input Data Statements 1. How many Ophthalmologist FTE positions are authorized? (S) 2. How many Low Vision Manager FTE positions for Ophthalmology Service are

authorized? (S) 3. How many Low Vision Therapist FTE positions for Ophthalmology Service are

authorized? (S) 4. How many Orientation and Mobility Specialist (OMS) FTE positions for

Ophthalmology Service are authorized? (S)



5. How many Blind Rehabilitation Outpatient Specialist (BROS) FTE positions for Ophthalmology Service are authorized? (S)

6. How many Ophthalmology Administrative FTE positions are authorized? (S)

D. Miscellaneous Input Data Statements 1. Is a Conference Room for Ophthalmology Service authorized? (Misc) 2. Is a Conference / Classroom for the Ophthalmology Education Area authorized?

(Misc)

5 OPHTHALMOLOGY SPACE CRITERIA A. FA 1: Ophthalmology Service Reception Area

1. Waiting, Ophthalmology (WTG06) ...................................... 130 NSF (12.1 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is one or two; provide WTG12 if the projected number of Ophthalmology Exam / Treatment Rooms is three or four; provide WTG18 if the projected number of Ophthalmology Exam / Treatment Rooms is five or six; provide WTG24 if the projected number of Ophthalmology Exam / Treatment Rooms is seven or eight; provide WTG30 if the projected number of Ophthalmology Exam / Treatment Rooms is nine or ten; provide WTG36 if the projected number of Ophthalmology Exam / Treatment Rooms is eleven or twelve; provide two WTG21 if the projected number of Ophthalmology Exam / Treatment Rooms is thirteen or fourteen; provide two WTG24 if the projected number of Ophthalmology Exam / Treatment Rooms is fifteen or sixteen; provide two WTG27 if the projected number of Ophthalmology Exam / Treatment Rooms is seventeen or eighteen; provide two WTG30 if the projected number of Ophthalmology Exam / Treatment Rooms is nineteen or twenty; provide two WTG33 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-one or twenty-two; provide two WTG36 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-three or twenty-four; provide two WTG39 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-five or twenty-six; provide three WTG28 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-seven or twenty-eight; provide three WTG30 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty-eight.

WTG06: Allocated area accommodates four standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total six people. (130 NSF)

WTG12: Allocated area accommodates ten standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total twelve people. (260 NSF)

WTG18: Allocated area accommodates fourteen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total eighteen people. (370 NSF)

WTG21: Allocated area accommodates seventeen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty-one people. (440 NSF)



WTG24: Allocated area accommodates twenty standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty-four people. (520 NSF)

WTG27: Allocated area accommodates twenty-one standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total twenty-seven people. (535 NSF)

WTG28: Allocated area accommodates twenty-two standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total twenty-eight people. (540 NSF)

WTG30: Allocated area accommodates twenty-four standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total thirty people. (575 NSF)

WTG33: Allocated area accommodates twenty-seven standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total thirty-three people. (625 NSF)

WTG36: Allocated area accommodates twenty-eight standard chairs @ 9 NSF each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF each, and circulation; total thirty-six people. (675 NSF)

WTG39: Allocated area accommodates thirty-one standard chairs @ 9 NSF each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF each, and circulation; total thirty-nine people. (705 NSF)

2. Waiting, Ophthalmology Family (WTF03) ........................... 220 NSF (20.5 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates two standard chairs @ 9 NSF each, one bariatric chair at 14 NSF, one accessible space @ 10 NSF, one child table and chairs @ 50 NSF, and circulation; total eight people. (220 NSF)

3. Reception, Ophthalmology (RCP01) ....................................... 85 NSF (7.9 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and four; provide RCP02 if the total number of Ophthalmology Exam / Treatment Rooms is between five and eight; provide RCP03 if the total number of Ophthalmology Exam / Treatment Rooms is between nine and twelve; provide one RCP01 and one RCP03 if the total number of Ophthalmology Exam / Treatment Rooms is between thirteen and sixteen; provide one RCP02 and one RCP03 if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty; provide two RCP03 if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty.

RCP01: Allocated area accommodates one Receptionist FTE, patient privacy area, and circulation. (85 NSF)

RCP02: Allocated area accommodates two Receptionist FTEs, patient privacy area, and circulation. (260 NSF)

RCP03: Allocated area accommodates three Receptionist FTEs, patient privacy area, and circulation. (385 NSF)



4. Kiosk, Ophthalmology Patient Check-in (RCHK1) ................. 55 NSF (5.2 NSM) Provide two for Ophthalmology Service.

Allocated area accommodates one Display Kiosk, patient privacy area, and circulation.

5. Education / Resource Room, Ophthalmology Patient (PATE1) ........................................... 100 NSF (9.3 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and twelve; provide two if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twelve.

Allocated area accommodates two patients and two family members.

6. Toilet, Public (TNPG1) ............................................................. 60 NSF (5.6 NSM) Provide two for Ophthalmology Service.

Allocated area accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation.

7. Alcove, Wheelchair (CSWH1) .................................................. 30 NSF (2.8 NSM) Provide two for Ophthalmology Service.

B. FA 2: Ophthalmology Service Patient Area 1. Waiting, Ophthalmology Dilation (WTG02) ............................ 45 NSF (4.2 NSM)

Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one or two; provide WTG04 if the projected number of Ophthalmology Exam / Treatment Rooms is three or four; provide WTG06 if the projected number of Ophthalmology Exam / Treatment Rooms is five or six; provide WTG08 if the projected number of Ophthalmology Exam / Treatment Rooms is seven or eight; provide WTG10 if the projected number of Ophthalmology Exam / Treatment Rooms is nine or ten; provide WTG12 if the projected number of Ophthalmology Exam / Treatment Rooms is eleven or twelve; provide WTG14 if the projected number of Ophthalmology Exam / Treatment Rooms is thirteen or fourteen; provide WTG16 if the projected number of Ophthalmology Exam / Treatment Rooms is fifteen or sixteen; provide WTG18 if the projected number of Ophthalmology Exam / Treatment Rooms is seventeen or eighteen; provide WTG20 if the projected number of Ophthalmology Exam / Treatment Rooms is nineteen or twenty; provide WTG22 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-one or twenty-two; provide WTG24 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-three or twenty-four; provide WTG26 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-five or twenty-six; provide WTG28 if the projected number of Ophthalmology Exam / Treatment Rooms is twenty-seven or twenty-eight; provide WTG30 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty-eight.

WTG02: Allocated area accommodates one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total two people. (45 NSF)

WTG04: Allocated area accommodates two standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total four people. (100 NSF)




WTG08: Allocated area accommodates six standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total eight people. (170 NSF)

WTG10: Allocated area accommodates eight standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total ten people. (215 NSF)


WTG14: Allocated area accommodates twelve standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total fourteen people. (290 NSF)

WTG16: Allocated area accommodates twelve standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total sixteen people. (330 NSF)


WTG20: Allocated area accommodates sixteen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty people. (415 NSF)

WTG22: Allocated area accommodates eighteen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty-two people. (465 NSF)


WTG26: Allocated area accommodates twenty standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total twenty-six people. (530 NSF)



2. Consult Room / Viewing Room, Ophthalmology (PTSC1) ...................................................... 185 NSF (17.2 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates four people, Tele-retinal Reading.



3. Pre-Testing / Intake Room, Ophthalmology (OPPT1) ........ 130 NSF (12.1 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and four; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is between five and eight; provide an additional two if the total number of Ophthalmology Exam / Treatment Rooms is between nine and twelve; provide an additional three if the total number of Ophthalmology Exam / Treatment Rooms is between twelve and sixteen; provide an additional four if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty; provide an additional five if the total number of Ophthalmology Exam / Treatment Rooms is between twenty-one and twenty-four; provide an additional six if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates corneal tomography unit, autorefractor and tonometer.

4. Exam / Treatment Room, Ophthalmology (OPET1) ........... 130 NSF (12.1 NSM) Provide one for every increment of 2,250 projected annual Ophthalmology Service clinic stops (Stop Code 407) if Ophthalmology Service is Non-Affiliated, minimum workload to generate a room is 563; provide one for every increment of 1,800 projected annual Ophthalmology Service clinic stops (Stop Code 407) if Ophthalmology Service is Affiliated, minimum workload to generate a room is 450. (Refer to Table 1).

Allocated area accommodates patient exam chair, phoropter, slit lamp, refraction desk, and keratometer.

5. Exam Room, Ophthalmology PA (EXPA1) ......................... 130 NSF (12.1 NSM) Minimum one; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is greater than ten.

This space is for use of Physician Assistant (PA) and Nurse Practitioner to conduct patient evaluation prior to an Ophthalmic Procedure.

6. Procedure Room, Ophthalmology (OPPR1) ....................... 225 NSF (21.0 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates patient stretcher chair, operating microscope, exam light and medical distribution system.

7. Visual Fields Room, Ophthalmology (OPVF1) ................... 130 NSF (12.1 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates automated perimeter.



8. Photography Room, Ophthalmology (OPPH1) .................. 185 NSF (17.2 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates retinal imaging system, slit lamp, and fundus camera.

9. Ultrasound, Ophthalmology (OPUS1) ................................ 130 NSF (12.1 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates an ophthalmic ultrasound.

10. Tomography Room, Ophthalmology (OPOC1) .................. 130 NSF (12.1 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Ophthalmology Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates two OCTs.

11. Imaging Room, Ophthalmology (OPIM1) ............................ 130 NSF (12.1 NSM) Provide one if the total number of Ophthalmology Exam / Treatment Rooms is greater than twelve.

Allocated area accommodates specular microscope and corneal topographer.

12. YAG Laser Room, Ophthalmology (OPLS1) ...................... 130 NSF (12.1 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates a YAG laser.

13. Retinal Photocoagulation Laser Room, Ophthalmology (OPLS2) ..................................................... 130 NSF (12.1 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates a retinal photocoagulator laser.

14. SLT Laser Room, Ophthalmology (OPLS3) ....................... 130 NSF (12.1 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates SLT laser.

15. Electrodiagnostics Room, Ophthalmology (OPED1)......... 130 NSF (12.1 NSM) Provide one if an Electrodiagnostics Room for Ophthalmology Service is authorized.

Allocated area accommodates Electroretinography (ERG) and Visual Evoked Potential (VEP) devices.



16. Specialty Testing Room, Ophthalmology (OPST1) ........... 185 NSF (17.2 NSM) Provide one if a Specialty Testing Room for Ophthalmology Service is authorized.

Allocated area accommodates space for clinic specific equipment / emerging technology testing.

17. Low Vision / Polytrauma Training Room, Ophthalmology (OPLV1)........................... 185 NSF (17.2 NSM) Provide one if a Low Vision / Polytrauma Training Room for Ophthalmology Service is authorized; provide two if an Advanced Low Vision Clinic for Ophthalmology Service is authorized.

Allocated area accommodates three low vision training workstations.

18. Storage, Ophthalmology Low Vision / Polytrauma Training Room (STLV1) ....................................... 80 NSF (7.5 NSM) Provide one if a Low Vision / Polytrauma Training Room for Ophthalmology Service is authorized.

19. Toilet, Ophthalmology Patient (TPG01) .................................. 60 NSF (5.6 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

C. FA 3: Ophthalmology Service Support Area 1. Supply Room, Clean (CSUC1) ................................................. 80 NSF (7.5 NSM)

Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and four; provide CSUC2 if the projected number of Ophthalmology Exam / Treatment Rooms is between five and eight; provide CSUC3 if the projected number of Ophthalmology Exam / Treatment Rooms is between nine and twelve; provide CSUC4 if the projected number of Ophthalmology Exam / Treatment Rooms is between thirteen and sixteen; provide CSUC5 if the projected number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty; provide CSUC6 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty.

CSUC2: allocated area is 100 NSF; CSUC3: allocated area is 120 NSF; CSUC4: allocated area is 140 NSF; CSUC5: allocated area is 160 NSF; CSUC6: allocated area is 180 NSF.

2. Utility Room, Soiled (CSUS1) .................................................. 40 NSF (3.8 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and ten; provide CSUS2 if the projected number of Ophthalmology Exam / Treatment Rooms is between eleven and twenty; provide CSUS3 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty.

CSUS2: allocated area is 60 NSF; CSUS3: allocated area is 80 NSF.



3. Medication Preparation Room (CSMP1) ................................. 80 NSF (7.5 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and six; provide CSMP2 if the projected number of Ophthalmology Exam / Treatment Rooms is between seven and twelve; provide CSMP3 if the projected number of Ophthalmology Exam / Treatment Rooms is between thirteen and eighteen; provide CSMP4 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than eighteen.

CSMP2: allocated area is 100 NSF; CSMP3: allocated area is 120 NSF; CSMP4: allocated area is 140 NSF.

4. Storage, Equipment (STEQ1) .................................................. 80 NSF (7.5 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and four; provide STEQ2 if the projected number of Ophthalmology Exam / Treatment Rooms is between five and eight; provide STEQ3 if the projected number of Ophthalmology Exam / Treatment Rooms is between nine and twelve; provide STEQ4 if the projected number of Ophthalmology Exam / Treatment Rooms is between thirteen and sixteen; provide STEQ5 if the projected number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty; provide STEQ6 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty.

STEQ2: allocated area is 100 NSF; STEQ3: allocated area is 140 NSF; STEQ4: allocated area is 180 NSF; STEQ5: allocated area is 220 NSF; STEQ6: allocated area is 260 NSF.

5. Alcove, Medical Equipment (CSME1) ..................................... 30 NSF (2.8 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and twelve; provide two if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twelve.

6. Alcove, Wheelchair (CSWH1) .................................................. 30 NSF (2.8 NSM) Provide one for Ophthalmology Service.

7. Housekeeping Aides Closet (HAC) (BGSH1) ......................... 60 NSF (5.6 NSM) Provide one for Ophthalmology Service.

8. Storage, Clinic Supplies (STCS1) ........................................... 80 NSF (7.5 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and four; provide STCS2 if the projected number of Ophthalmology Exam / Treatment Rooms is between five and eight; provide STCS3 if the projected number of Ophthalmology Exam / Treatment Rooms is between nine and twelve; provide STCS4 if the projected number of Ophthalmology Exam / Treatment Rooms is between thirteen and sixteen; provide STCS5 if the projected number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty; provide STCS6 if the projected number of Ophthalmology Exam / Treatment Rooms is between twenty-one and twenty-four; provide STCS7 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

STCS2: allocated area is 100 NSF; STCS3: allocated area is 120 NSF; STCS4: allocated area is 140 NSF; STCS5: allocated area is 160 NSF; STCS6: allocated area is 180 NSF; STCS7: allocated area is 200 NSF.



9. Reusable Medical Equipment (RME) Room (SPRM1) ............ 80 NSF (7.5 NSM) Provide one for Ophthalmology Service.

D. FA 4: Ophthalmology Service Staff and Administrative Area 1. Office, Ophthalmology Service Chief (OFA09) .................... 100 NSF (9.3 NSM)

Provide one for Ophthalmology Service.

2. Office, Ophthalmology Service Assistant Chief (OFA09) ... 100 NSF (9.3 NSM) Provide one for Ophthalmology Service.

3. Workstation, Program Support Assistant (OFA07) ............... 56 NSF (5.3 NSM) Provide one for Ophthalmology Service.

4. Waiting (WTG03) ...................................................................... 80 NSF (7.5 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates one standard chair @ 9 NSF, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people. (80 NSF)

5. Workstation, Ophthalmology Provider (OFA07) .................... 56 NSF (5.3 NSM) Provide one per each Ophthalmologist FTE position authorized.

6. Touchdown Station, Ophthalmology (SSWR1) ...................... 75 NSF (7.0 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and eight; provide an additional one if the projected number of Ophthalmology Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the projected number of Ophthalmology Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the projected number of Ophthalmology Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates a two-person touchdown workstation.

7. Office, Social Work / Intake / Adjustment Counseling (OFA04) .... 120 NSF (11.2 NSM) Provide one if an Advanced Low Vision Clinic for Ophthalmology Service is authorized or if a VIST Coordinator FTE position for Ophthalmology Service is authorized.

8. Workstation, Low Vision Provider (OFA07) ........................... 56 NSF (5.3 NSM) Provide one per each Low Vision Manager, Low Vision Therapist, Orientation and Mobility Specialist (OMS) and Blind Rehabilitation Outpatient Specialist (BROS) FTE position for Ophthalmology Service authorized.

9. Office, Clinic Manager (OFA09) ............................................ 100 NSF (9.3 NSM) Provide one for Ophthalmology Service.

10. Workstation, Administration (OFA07) .................................... 56 NSF (5.3 NSM) Provide one per each Ophthalmology Administrative FTE position authorized.

Allocated workstations for call center / surgery scheduler.

11. Support Equipment Area (SASE1) .......................................... 80 NSF (7.5 NSM) Provide one for Ophthalmology Service.

12. Copy / Office Supply Room (SACS1) .................................... 100 NSF (9.3 NSM) Provide one for Ophthalmology Service.



13. Conference Room (CFR01) ................................................. 240 NSF (22.3 NSM) Provide one if a Conference Room for Ophthalmology Service is authorized.

Allocated area accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

14. Lounge, Staff (SSLG1) ......................................................... 140 NSF (13.1 NSM) Provide one if the projected number of Ophthalmology Exam / Treatment Rooms is between one and six; provide SSLG2 if the projected number of Ophthalmology Exam / Treatment Rooms is between seven and twelve; provide SSLG3 if the projected number of Ophthalmology Exam / Treatment Rooms is between thirteen and eighteen; provide SSLG4 if the projected number of Ophthalmology Exam / Treatment Rooms is greater than eighteen.

SSLG2: allocated area is 260 NSF; SSLG3: allocated area is 380 NSF; SSLG4: allocated area is 500 NSF.

15. Locker Room, Staff Personal Property (SSLK1) .................... 65 NSF (6.1 NSM) Provide one for Ophthalmology Service.

Allocated area accommodates twenty-two two-tier or thirty-three three-tier personal property lockers.

16. Toilet, Staff (TNPG1) ................................................................ 60 NSF (5.6 NSM) Provide two for Ophthalmology Service.

Allocated area accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation. (60NSF)

E. FA 5: Ophthalmology Service Education Area: 1. Office, Ophthalmology Residency Director (OFA09)........... 100 NSF (9.3 NSM)

Provide one if an Ophthalmology Residency Program is authorized.

2. Collaboration Room, Resident / Fellow (SSCR1) ............... 185 NSF (17.2 NSM) Provide one if an Ophthalmology Residency or an Ophthalmology Fellowship Program is authorized.

Allocated area accommodates six people.

3. Conference Room / Classroom (CLR10) ............................ 545 NSF (50.7 NSM) Provide one if a Conference / Classroom for the Ophthalmology Education Area is authorized and if Ophthalmology Residency or Ophthalmology Fellowship is authorized.

Allocated area accommodates sixteen task chairs @ 7.5 NSF each, eight 5’-0” x 2’-0” tables at 10 NSF each, one credenza @ 8 NSF, one lectern @ 9 NSF, and circulation; total sixteen people. (545NSF)

6 OPTOMETRY SERVICE INPUT DATA STATEMENTS A. Mission Input Data Statements

1. Is Optometry Service authorized? (M) 2. Is the Optometry Program Affiliated? (M) 3. Is an Electrodiagnostics Room for Optometry Service authorized? (M) 4. Is a Specialty Testing Room for Optometry Service authorized? (M) 5. Is a Low Vision / Polytrauma Training Room for Optometry Service authorized? (M)



6. Is an Advanced Low Vision Clinic for Optometry Service authorized? (M) 7. Is a VICTORS Vision Rehabilitation Service for Optometry Service authorized? (M) 8. Is a Polytrauma Rehabilitation Network Site / Center Vision Rehabilitation Service for

Optometry Service authorized? (M) 9. Is a VIST Coordinator FTE position for Optometry Service authorized? (M) 10. Is a Blind Rehabilitation Outpatient Specialist (BROS) Coordinator FTE position for

Optometry Service authorized? (M) 11. Is an Optometry Residency Program authorized? (M) 12. Is an Optometry Externship Program authorized? (M)

B. Workload Input Data Statements 1. How many annual Optometry clinic stops (Stop Code 408) are projected? (W)

C. Staffing Input Data Statements 1. How many Optometry Provider FTE positions are authorized? (S) 2. How many Low Vision Manager FTE positions for Optometry Service are

authorized? (S) 3. How many Low Vision Therapist FTE positions for Optometry Service are

authorized? (S) 4. How many Orientation and Mobility Specialist (OMS) FTE positions for Optometry

Service are authorized? (S) 5. How many Blind Rehabilitation Outpatient Specialist (BROS) FTE positions for

Optometry Service are authorized? (S) 6. How many Optometry Administrative FTE positions are authorized? (S)

D. Miscellaneous Input Data Statements 1. How many Optometry FTEs will work on peak shift? (Misc) 2. Is a Conference Room for Optometry Service authorized? (Misc) 3. Is a Conference / Classroom for the Optometry Education Area authorized? (Misc)



7 OPTOMETRY SERVICE SPACE CRITERIA A. FA 6: Optometry Service Reception Area

1. Waiting, Optometry (WTG06) .............................................. 130 NSF (12.1 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is one or two; provide WTG12 if the projected number of Optometry Exam / Treatment Rooms is three or four; provide WTG18 if the projected number of Optometry Exam / Treatment Rooms is five or six; provide WTG24 if the projected number of Optometry Exam / Treatment Rooms is seven or eight; provide WTG30 if the projected number of Optometry Exam / Treatment Rooms is nine or ten; provide WTG36 if the projected number of Optometry Exam / Treatment Rooms is eleven or twelve; provide two WTG21 if the projected number of Optometry Exam / Treatment Rooms is thirteen or fourteen; provide two WTG24 if the projected number of Optometry Exam / Treatment Rooms is fifteen or sixteen; provide two WTG27 if the projected number of Optometry Exam / Treatment Rooms is seventeen or eighteen; provide two WTG30 if the projected number of Optometry Exam / Treatment Rooms is nineteen or twenty; provide two WTG33 if the projected number of Optometry Exam / Treatment Rooms is twenty-one or twenty-two; provide two WTG36 if the projected number of Optometry Exam / Treatment Rooms is twenty-three or twenty-four; provide two WTG39 if the projected number of Optometry Exam / Treatment Rooms is twenty-five or twenty-six; provide three WTG28 if the projected number of Optometry Exam / Treatment Rooms is twenty-seven or twenty-eight; provide three WTG30 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty-eight.




WTG21: Allocated area accommodates seventeen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty-one people. (440 NSF)


WTG27: Allocated area accommodates twenty-one standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total twenty-seven people. (535 NSF)





WTG33: Allocated area accommodates twenty-seven standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total thirty-three people. (625 NSF)

WTG36: Allocated area accommodates twenty-eight standard chairs @ 9 NSF each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF each, and circulation; total thirty-six people. (675 NSF)

WTG39: Allocated area accommodates thirty-one standard chairs @ 9 NSF each, four bariatric chairs @ 14 NSF each, four accessible spaces @ 10 NSF each, and circulation; total thirty-nine people. (705 NSF)

2. Waiting, Optometry Family (WTF03) ................................... 220 NSF (20.5 NSM) Provide one for Optometry Service.

Allocated area accommodates two standard chairs @ 9 NSF each, one bariatric chair at 14 NSF, one accessible space @ 10 NSF, one child table and chairs @ 50 NSF, and circulation; total eight people. (220 NSF)

3. Reception, Optometry (RCP01) ............................................... 85 NSF (7.9 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and four; provide RCP02 if the total number of Optometry Exam / Treatment Rooms is between five and eight; provide RCP03 if the total number of Optometry Exam / Treatment Rooms is between nine and twelve; provide one RCP01 and one RCP03 if the total number of Optometry Exam / Treatment Rooms is between thirteen and sixteen; provide one RCP02 and one RCP03 if the total number of Optometry Exam / Treatment Rooms is between seventeen and twenty; provide two RCP03 if the total number of Optometry Exam / Treatment Rooms is greater than twenty.

RCP01: Allocated area accommodates one Receptionist FTE, patient privacy area, and circulation. (85 NSF)

RCP02: Allocated area accommodates two Receptionist FTEs, patient privacy area, and circulation. (260 NSF)

RCP03: Allocated area accommodates three Receptionist FTEs, patient privacy area, and circulation. (385 NSF)

4. Kiosk, Optometry Patient Check-in (RCHK2) ....................... 105 NSF (9.8 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and eight; provide RCHK3 if the projected number of Optometry Exam / Treatment Rooms is greater than eight.

RCHK2: Allocated area accommodates two Display Kiosks, patient privacy area, and circulation. (105 NSF)

RCHK3: Allocated area accommodates three Display Kiosks, patient privacy area, and circulation. (160 NSF)



5. Education / Resource Room, Optometry Patient (PATE1) ................................................... 100 NSF (9.3 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and twelve; provide an additional one if the projected number of Optometry Exam / Treatment Rooms is greater than twelve.

Allocated area accommodates two patients and two family members.

6. Toilet, Public (TNPG1) ............................................................. 60 NSF (5.6 NSM) Provide two for Optometry Service.

Allocated area accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation. (60 NSF)

7. Alcove, Wheelchair (CSWH1) .................................................. 30 NSF (2.8 NSM) Provide two for Optometry Service.

B. FA 7: Optometry Service Patient Area 1. Waiting, Optometry Dilation (WTG02) .................................... 45 NSF (4.2 NSM)

Provide one if the projected number of Optometry Exam / Treatment Rooms is between one or two; provide WTG04 if the projected number of Optometry Exam / Treatment Rooms is three or four; provide WTG06 if the projected number of Optometry Exam / Treatment Rooms is five or six; provide WTG08 if the projected number of Optometry Exam / Treatment Rooms is seven or eight; provide WTG10 if the projected number of Optometry Exam / Treatment Rooms is nine or ten; provide WTG12 if the projected number of Optometry Exam / Treatment Rooms is eleven or twelve; provide WTG14 if the projected number of Optometry Exam / Treatment Rooms is thirteen or fourteen; provide WTG16 if the projected number of Optometry Exam / Treatment Rooms is fifteen or sixteen; provide WTG18 if the projected number of Optometry Exam / Treatment Rooms is seventeen or eighteen; provide WTG20 if the projected number of Optometry Exam / Treatment Rooms is nineteen or twenty; provide WTG22 if the projected number of Optometry Exam / Treatment Rooms is twenty-one or twenty-two; provide WTG24 if the projected number of Optometry Exam / Treatment Rooms is twenty-three or twenty-four; provide WTG26 if the projected number of Optometry Exam / Treatment Rooms is twenty-five or twenty-six; provide WTG28 if the projected number of Optometry Exam / Treatment Rooms is twenty-seven or twenty-eight; provide WTG30 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty-eight.

WTG02: Allocated area accommodates one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total two people. (45 NSF)

WTG04: Allocated area accommodates two standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total four people. (100 NSF)


WTG08: Allocated area accommodates six standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total eight people. (170 NSF)



WTG10: Allocated area accommodates eight standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total ten people. (215 NSF)


WTG14: Allocated area accommodates twelve standard chairs @ 9 NSF each, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total fourteen people. (290 NSF)

WTG16: Allocated area accommodates twelve standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total sixteen people. (330 NSF)


WTG20: Allocated area accommodates sixteen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty people. (415 NSF)

WTG22: Allocated area accommodates eighteen standard chairs @ 9 NSF each, two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and circulation; total twenty-two people. (465 NSF)


WTG26: Allocated area accommodates twenty standard chairs @ 9 NSF each, three bariatric chairs @ 14 NSF each, three accessible spaces @ 10 NSF each, and circulation; total twenty-six people. (530 NSF)



2. Consult Room / Viewing Room, Optometry (PTSC1) ........ 185 NSF (17.2 NSM) Provide one for Optometry Service.

Allocated area accommodates four people, including Teleretinal Reading.

3. Pre-Testing / Intake Room, Optometry (OPPT2) ................ 130 NSF (12.1 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and four; provide an additional one if the total number of Optometry Exam / Treatment Rooms is between five and eight; provide an additional two if the total number of Optometry Exam / Treatment Rooms is between nine and twelve; provide an additional three if the total number of Optometry Exam / Treatment Rooms is



between thirteen and sixteen; provide an additional four is the total number of Optometry Exam / Treatment Rooms is greater than sixteen.

Allocated area accommodates corneal topography unit, autorefractor and tonometer.

4. Exam / Treatment Room, Optometry (OPET2) ................... 130 NSF (12.1 NSM) Provide one for every increment of 2,400 projected annual Optometry clinic stops (Stop Code 408) if Optometry Program is Non-Affiliated, minimum workload to generate a room is 480; provide one for every increment of 1,920 projected annual Optometry clinic stops (Stop Code 408) if Optometry Program is Affiliated, minimum workload to generate a room is 384. (Refer to Table 1).

Allocated area accommodates patient exam chair, phoropter, slit lamp, and refraction desk.

5. Visual Fields Room, Optometry (OPVF2) ........................... 130 NSF (12.1 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Optometry Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Optometry Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Optometry Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates automated perimeter.

6. Photography Room, Optometry (OPPH2) .......................... 185 NSF (17.2 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Optometry Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Optometry Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the total number of Optometry Exam / Treatment Rooms are greater than twenty-four.

Allocated area accommodates fluorescein / indocyanine retinal imaging system, slit lamp and fundus camera.

7. Ultrasound, Optometry (OPUS2) ........................................ 130 NSF (12.1 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and twelve; provide an additional one if the total number of Optometry Exam / Treatment Rooms is between thirteen and twenty-four; provide an additional two if the total number of Optometry Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates an ophthalmic ultrasound.

8. Tomography Room, Optometry (OPOC2) .......................... 130 NSF (12.1 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is between one and eight; provide an additional one if the total number of Optometry Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the total number of Optometry Exam / Treatment Rooms is greater than sixteen.

Allocated area accommodates two OCTs.

9. Imaging Room, Optometry (OPIM2) .................................... 130 NSF (12.1 NSM) Provide one if the total number of Optometry Exam / Treatment Rooms is greater than twelve.



Allocated area accommodates specular microscope and corneal topographer.

10. Electrodiagnostics Room, Optometry (OPED2)................. 130 NSF (12.1 NSM) Provide one if an Electrodiagnostics Room for Optometry Service is authorized.

Allocated area accommodates electroretinographer and visual evoked potential (VEP).

11. Specialty Testing Room, Optometry (OPST2) ................... 185 NSF (17.2 NSM) Provide one if a Specialty Testing Room for Optometry Service is authorized.

Allocated area accommodates space for clinic specific equipment / emerging technology testing.

12. Low Vision Exam / Therapy / Training Room, Optometry (OPLV2) .................. 185 NSF (17.2 NSM) Provide one for Optometry Service.


13. Storage, Low Vision Supplies (STLV1) .................................. 80 NSF (7.5 NSM) Provide one for Optometry Service.

14. Low Vision / Polytrauma Training Room, Optometry (OPLV2) .............. 185 NSF (17.2 NSM) Provide one if a Low Vision / Polytrauma Training Room for Optometry Service is authorized; provide two if an Advanced or a VICTORS or a Polytrauma Rehabilitation Network Site / Center Vision Rehabilitation Service for Optometry Service is authorized.


15. Storage, Optometry Low Vision / Polytrauma Training Room (STLV1) ....................................... 80 NSF (7.5 NSM) Provide one per each Optometry Low Vision / Polytrauma Training Room.

16. Consult, VIST Coordinator (PTSC2) ................................... 130 NSF (12.1 NSM) Provide one if a VIST Coordinator FTE position for Optometry Service is authorized.

Locate near Low Vision Exam / Therapy / Training Room.

17. Consult, BROS Coordinator (PTSC2) ................................. 130 NSF (12.1 NSM) Provide one if a Blind Rehabilitation Outpatient Specialist (BROS) Coordinator FTE position for Optometry Service is authorized.

Locate near Low Vision Exam / Therapy / Training Room.

18. Storage, BROS (STBRO) ......................................................... 80 NSF (7.5 NSM) Provide one if a BROS Coordinator FTE position for Optometry Service is authorized.

Locate adjacent to the BROS Coordinator Consult.

19. Toilet, Optometry Patient (TPG01) .......................................... 60 NSF (5.6 NSM) Provide two for Optometry Service.

Allocated area accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation. (60NSF)



C. FA 8: Optometry Service Support Area 1. Supply Room, Clean (CSUC1) ................................................. 80 NSF (7.5 NSM)

Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and four; provide CSUC2 if the projected number of Optometry Exam / Treatment Rooms is between five and eight; provide CSUC3 if the projected number of Optometry Exam / Treatment Rooms is between nine and twelve; provide CSUC4 if the projected number of Optometry Exam / Treatment Rooms is between thirteen and sixteen; provide CSUC5 if the projected number of Optometry Exam / Treatment Rooms is between seventeen and twenty; provide CSUC6 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty.

CSUC2: allocated area is 100 NSF; CSUC3: allocated area is 120 NSF; CSUC4: allocated area is 140 NSF; CSUC5: allocated area is 160 NSF; CSUC6: allocated area is 180 NSF.

2. Utility Room, Soiled (CSUS1) .................................................. 40 NSF (3.8 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and ten; provide CSUS2 if the projected number of Optometry Exam / Treatment Rooms is between eleven and twenty; provide CSUS3 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty.

CSUS2: allocated area is 60 NSF; CSUS3: allocated area is 80 NSF.

3. Medication Room, Optometry (CSMR1) ................................. 80 NSF (7.5 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and six; provide CSMR2 if the projected number of Optometry Exam / Treatment Rooms is between seven and twelve; provide CSMR3 if the projected number of Optometry Exam / Treatment Rooms is between thirteen and eighteen; provide CSMR4 if the projected number of Optometry Exam / Treatment Rooms is greater than eighteen.

CSMR2: allocated area is 100 NSF; CSMR3: allocated area is 120 NSF; CSMR4: allocated area is 140 NSF.

4. Storage, Equipment (STEQ1) .................................................. 80 NSF (7.5 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and four; provide STEQ2 if the projected number of Optometry Exam / Treatment Rooms is between five and eight; provide STEQ3 if the projected number of Optometry Exam / Treatment Rooms is between nine and twelve; provide STEQ4 if the projected number of Optometry Exam / Treatment Rooms is between thirteen and sixteen; provide STEQ5 if the projected number of Optometry Exam / Treatment Rooms is between seventeen and twenty; provide STEQ6 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty.

STEQ2: allocated area is 100 NSF; STEQ3: allocated area is 140 NSF; STEQ4: allocated area is 180 NSF; STEQ5: allocated area is 220 NSF; STEQ6: allocated area is 260 NSF.

5. Alcove, Medical Equipment (CSME1) ..................................... 30 NSF (2.8 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and twelve; provide two if the projected number of Optometry Exam / Treatment Rooms is greater than twelve.

6. Alcove, Wheelchair (CSWH1) .................................................. 30 NSF (2.8 NSM)



Provide one for Optometry Service.

7. Housekeeping Aides Closet (HAC) (BGSH1) ......................... 60 NSF (5.6 NSM) Provide one for Optometry Service.

8. Storage, Clinic Supplies (STCS1) ........................................... 80 NSF (7.5 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and four; provide STCS2 if the projected number of Optometry Exam / Treatment Rooms is between five and eight; provide STCS3 if the projected number of Optometry Exam / Treatment Rooms is between nine and twelve; provide STCS4 if the projected number of Optometry Exam / Treatment Rooms is between thirteen and sixteen; provide STCS5 if the projected number of Optometry Exam / Treatment Rooms is between seventeen and twenty; provide STCS6 if the projected number of Optometry Exam / Treatment Rooms is between twenty-one and twenty-four; provide STCS7 if the projected number of Optometry Exam / Treatment Rooms is greater than twenty-four.

STCS2: allocated area is 100 NSF; STCS3: allocated area is 120 NSF; STCS4: allocated area is 140 NSF; STCS5: allocated area is 160 NSF; STCS6: allocated area is 180 NSF; STCS7: allocated area is 200 NSF.

9. Reusable Medical Equipment (RME) Room (SPRM1) ............ 80 NSF (7.5 NSM) Provide one for Optometry Service.

D. FA 9: Optometry Service Staff and Administrative Area 1. Office, Optometry Service Chief (OFA09) ............................ 100 NSF (9.3 NSM)

Provide one for Optometry Service.

2. Office, Optometry Service Assistant Chief (OFA09) ........... 100 NSF (9.3 NSM) Provide one for Optometry Service.

3. Workstation, Program Support Assistant (OFA07) ............... 56 NSF (5.3 NSM) Provide one for Optometry Service.

4. Waiting (WTG03) ...................................................................... 80 NSF (7.5 NSM) Provide one for Optometry Service.

Allocated area accommodates one standard chair @ 9 NSF, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people.

5. Workstation, Optometry Provider (OFA07) ............................ 56 NSF (5.3 NSM) Provide one per each Optometry Provider FTE position authorized.

6. Touchdown Station, Optometry (SSWR1) .............................. 75 NSF (7.0 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and eight; provide an additional one if the projected number of Optometry Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the projected number of Optometry Exam / Treatment Rooms is between seventeen and twenty-four; provide an additional three if the projected number of Optometry Exam / Treatment Rooms is greater than twenty-four.

Allocated area accommodates a two-person touchdown workstation.



7. Office, Social Work / Intake / Adjustment Counseling (OFA04) .... 120 NSF (11.2 NSM) Provide one if a VIST Coordinator FTE position for Optometry Service is authorized.

8. Workstation, Low Vision Provider (OFA07) ........................... 56 NSF (5.3 NSM) Provide one per each Low Vision Manager, Low Vision Therapist, Orientation and Mobility Specialist (OMS) and Blind Rehabilitation Outpatient Specialist (BROS) FTE position for Optometry Service authorized.

9. Office, Clinic Manager (OFA09) ............................................ 100 NSF (9.3 NSM) Provide one for Optometry Service.

10. Workstation, Administration (OFA07) .................................... 56 NSF (5.3 NSM) Provide one per each Optometry Administrative FTE position authorized.

Allocated workstations for administrative and medical support personnel.

11. Support Equipment Area (SASE1) .......................................... 80 NSF (7.5 NSM) Provide one for Optometry Service.

12. Copy / Office Supply Room (SACS1) .................................... 100 NSF (9.3 NSM) Provide one for Optometry Service.

13. Conference Room (CFR01) ................................................. 240 NSF (22.3 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and twelve; provide CFR02 if the projected number of Optometry Exam / Treatment Rooms is greater than twelve if a Conference Room for Optometry Service is authorized.

CFR01: Allocated area accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people. (240 NSF)

CFR02: Allocated area accommodates ten conference chairs @ 7.5 NSF each, four 5’-0” x 2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total ten people. (300 NSF)

14. Lounge, Staff (SSLG1) ......................................................... 140 NSF (13.1 NSM) Provide one if the projected number of Optometry Exam / Treatment Rooms is between one and six; provide SSLG2 if the projected number of Optometry Exam / Treatment Rooms is between seven and twelve; provide SSLG3 if the projected number of Optometry Exam / Treatment Rooms is between thirteen and eighteen; provide SSLG4 if the projected number of Optometry Exam / Treatment Rooms is greater than eighteen.

SSLG2: allocated area is 260 NSF; SSLG3: allocated area is 380 NSF; SSLG4: allocated area is 500 NSF.

15. Locker Room, Staff Personal Property (SSLK1) .................... 65 NSF (6.1 NSM) Provide one for Optometry Service.

Allocated area accommodates twenty-two two-tier or thirty-three three-tier personal property lockers.



16. Toilet, Staff (TNPG1) ................................................................ 60 NSF (5.6 NSM) Provide one if the total number of FTE positions working on peak shift is between one and twenty-five; provide an additional one if the total number of FTE positions working on peak shift is greater than twenty-five.

Allocated area accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation. (60 NSF)

E. FA 10: Optometry Service Education Area 1. Office, Optometry

Residency Director / Coordinator (OFA09) .......................... 100 NSF (9.3 NSM) Provide one if an Optometry Residency Program is authorized.

2. Office, Optometry Externship Director / Coordinator (OFA09) .......................... 100 NSF (9.3 NSM) Provide one if an Optometry Externship Program is authorized.

3. Collaboration Room, Resident / Extern (SSCR1) ............... 185 NSF (17.2 NSM) Provide one if Optometry Residency or Optometry Externship Program is authorized.

Allocated area accommodates six people.

4. Conference Room / Classroom (CFR02) ............................ 300 NSF (27.9 NSM) Provide one if a Conference / Classroom for the Optometry Education Area is authorized and if Optometry Residency or if Optometry Externship Program is authorized.

Allocated area accommodates ten conference chairs @ 7.5 NSF each, four 5’-0” x 2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total ten people. (300 NSF)

8 OPTICAL FITTING AREA INPUT DATA STATEMENTS A. Mission Input Data Statements

1. Is an Optical Fitting Area authorized? (M) 2. Is Contact Lens Care authorized? (M)

B. Workload Input Data Statements None

C. Staffing Input Data Statements None

D. Miscellaneous Input Data Statements None



9 OPTICAL FITTING SPACE CRITERIA A. FA 11: Optical Fitting Area

1. Fitting and Dispensing Area, Eyeglasses (OPFD1) ........... 200 NSF (18.6 NSM) Provide one if the projected number of Ophthalmology and Optometry Exam / Treatment Rooms is between one and eight; provide an additional one if the projected number of Ophthalmology and Optometry Exam / Treatment Rooms is between nine and sixteen; provide an additional two if the projected number of Ophthalmology and Optometry Exam / Treatment Rooms is greater than sixteen and if an Optical Fitting Area is authorized.

Allocated area accommodates optical cabinet display, dispensing table, spectacle warmer, automated & manual lensometer.

2. Fitting and Dispensing Area, Contact Lens (OPCL1) ........ 160 NSF (14.9 NSM) Provide one if Contact Lens Care is authorized.

Allocated area accommodates dispensing table, automated and manual lensometer. This room shall be provided within the Optometry Patient Area.

3. Storage, Frames (STOP1) ........................................................ 80 NSF (7.5 NSM) Provide one if an Optical Fitting Area is authorized.

4. Storage, Contact Lens (STOP1) .............................................. 80 NSF (7.5 NSM) Provide one if Contact Lens Care is authorized.

This room may be placed within the Optometry Patient Area.

10 PLANNING AND DESIGN CONSIDERATIONS A. Net-to-department gross factor (NTDG) for Eye Clinic: Ophthalmology and Optometry

Services is 1.60. This number when multiplied by the programmed net square feet (NSF) area determines the departmental gross square feet (DGSF).

B. General

1. This chapter allocates Ophthalmology and Optometry clinic space separately in order to accommodate facilities that co-locate both services, facilities that provide Ophthalmology and Optometry services in separate areas within the facility, and facilities where only one service, either Ophthalmology or Optometry, are provided.

2. The Program for Design (PFD) Report produced by SEPS based on these criteria is intended to be a baseline standardized space program in terms of the number of spaces provided for the clinic as well as their net square footage (NSF). Planner may make changes to PFD values for a project, provided reasoning is entered in the Comment field of each room affected for approval and approval is granted by reviewing government official; same principle applies to the Project Room Contents (PRC).

3. Although Blind Rehabilitation Services are provided separately from VHA Eye Care Services, there is a close connection between both services and space allocated for Blind Rehabilitation may be provided within the clinic area.

4. Create welcoming environments for patients and families by reducing environmental stressors. Daylighting, views of nature, gardens, indoor plants, and nature photography may alleviate patient anxiety, and provide positive distractions in waiting



areas and treatment rooms. Consider physical layouts and design features that maximize non-institutional environmental aspects in order to provide a more therapeutic environment.

5. Where possible, locate clinics proximate to public parking and the main facility entrance to improve access and minimize travel distance for patients with limited vision.

6. Clearly define patient circulation and provide “visual queues” to facilitate ease of patient wayfinding. Create separate paths of travel where possible between patients and staff (“on stage” and “off stage”) to support privacy, safety and patient / staff satisfaction.

7. Design the Eye Clinic: Ophthalmology and Optometry Services to provide access to patients with different levels of ability. It should be fully accessible and to support patient privacy, dignity.

8. Comply with safety and ergonomics guidelines.

9. Design for flexibility and adaptability to accommodate future expansion.

10. Consider the effects of building vibration on sensitive equipment.

C. Reception Area

1. Provide audio and visual privacy at patient registration and patient check-out areas.

2. Provide Receptionists with visual access to the waiting room.

D. Patient Area

1. Consider locating treatment areas for high volume, quick turn-around patient visits near the waiting room(s).

2. Locate Pre-testing areas close to the waiting room(s) to accommodate patient flow into the clinic.

3. Locate Dilation Waiting close to Pre-Testing / Intake room and Exam / Treatment Rooms. This area should be provided with dimmable lighting and with the absence of exterior windows.

4. Provide dimmable lighting controlled at the refraction desk in Exam / Treatment Rooms. Maintain required clearances for exam chair reclining and for movement of the chair to accommodate wheelchair users.

5. The Visual Fields Room should be a quiet interior room with dimmable lighting.

6. The Photography Room should be provided with dimmable lighting.

7. The Laser Room should be provided with non-reflective surfaces both in the room finishes and equipment specification. An indicator light that read “Laser in Use” should be provided outside the entrance to the room.

8. The Electrodiagnostics Room should be a dark quiet space provided with dimmable lighting.

9. Low Vision Training Room should be provided with adequate electrical outlets to accommodate a variety of assistive devices. Provide dimmable lighting.



10. Specialty Testing Room should be flexible space designed to accommodate a variety of testing equipment as determined by each individual Ophthalmology or Optometry clinic.

E. Support Area

1. Centrally locate support areas to maximize staff and space efficiency.

F. Staff and Administrative Area

1. Locate the Staff Lounge, Locker / Room, and Staff Toilets convenient to staff work areas but separate from patient areas.

G. Optical Fitting Area

1. Optical Fitting services may be provided by the VA or may be subcontracted to an outside vendor.

2. The Optical Fitting Area may be collocated with the Clinic, located in a separate area within the facility, or collocated with Veterans Canteen Services.

3. The Contact Lens Fitting and Dispensing area shall be located within the Optometry Patient Area.



11 FUNCTIONAL RELATIONSHIPS Relationship of Ophthalmology and Optometry Services to services listed below:

TABLE 2: FUNCTIONAL RELATIONSHIP MATRIX SERVICE RELATIONSHIP REASONS

Emergency Department

3 C,G,I Engineering Service 3 I Environmental Management Service (EMS)

3 I Lobby 2 H Logistics Service 3 B PACT Primary Care Clinic 3 G,H, I Pharmacy Service 2 H,I Polytrauma Rehabilitation Center

3 H,I Prosthetics and Sensory Aids Service

3 H Psychology Service 3 H,I

Social Work Service 3 H,I Sterile Processing Service 3 B Surgical Service 3 G,H,I Veterans Canteen Service 3 H

Legend:

Relationship 1. Adjacent 2. Close / Same Floor 3. Close / Different Floor Acceptable 4. Limited Traffic 5. Separation Desirable

Reasons A. Common use of resources B. Accessibility of supplies C. Urgency of contact D. Noise or vibration E. Presence of odors or fumes F. Contamination hazard G. Sequence of work H. Patient’s convenience I. Frequent contact J. Need for security K. Others (specify) L. Closeness inappropriate



12 FUNCTIONAL DIAGRAMS Ophthalmology Service



Optometry Service

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